Organization
EXCEL GROWTH THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENIECE MARAGRITA' PAYNE (DIRECTOR)
(571) 330-8120
Entity
Organization
Contact information
Practice address
10105 S FULTON DR, FREDERICKSBURG, VA 22408-0260
(571) 931-7420
(877) 771-3419
Mailing address
10105 S FULTON DR, FREDERICKSBURG, VA 22408-0260
(571) 931-7420
(877) 771-3419
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
VA
225100000X
Physical Therapist
2305204162
VA
225200000X
Physical Therapy Assistant
2306000431
VA
225400000X
Rehabilitation Practitioner
—
VA
225600000X
Dance Therapist
—
VA
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
—
—
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
—
—
225X00000X
Occupational Therapist
—
—
235500000X
Speech/Language/Hearing Specialist/Technologist
—
VA
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
VA
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073788931
—
VA
Enumeration date
04/22/2008
Last updated
06/11/2019
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